Case report about early debut and severe clinical course of system type of juvenile rheumatoid arthritis, refractory to treatment with classic immunosuppressive agents and blocker of tumor necrosis factor is presented in this article. A successful application of chimeric antibodies to cd20+ b-lymphocytes rituximab in dose 375 mg/m2 of surface of body weekly intravenously are described. Rituximab infusions were carried out during 4 weeks. Patient took 2 treatment courses of rituximab. Extra articular symptoms of disease and acute inflammatory lesions in joints were stopped by 8 week. Range of motions in affected joints was increased. A new attack of disease developed in 22 weeks after acute respiratory infection. Increase of level of CD 19+ and CD 20+ b-lymphocytes in peripheral blood was the reason of repeated treatment course, including rituximab in the same scheme. Treatment initiated the development of clinical and laboratory remission, duration of it was equal 22 weeks.Key words: children, juvenile rheumatoid arthritis, rituximab
